Noninvasive assessment of segmental left ventricular wall motion: Its clinical relevance in detection of ischemia

M-mode echocardiographic mapping in differentiation of normal from dysfunctioning left ventricular myocardium. A study of patients with severe myocardial infarction and healthy controls

Seventeen severely ill patients with acute myocardial infarction (AMI) (12 men and 5 women; mean age 65) and 37 healthy persons with similar age and sex distribution were investigated. Regional left ventricular wall motion was studied in terms of mean wall velocity, in 16 segments, 8 basal and 8 apical, by M-mode echocardiographic (Echo) mapping from 6 probe positions. Adequate Echo registrations were obtained from 88% of the total of 864 segments. The best classification (88.5%) of normal and infarcted segments was obtained with a -30% deviation of mean systolic wall velocity (Vmean) values from the mean values of the control segments (CS). Non-infarcted segments (NIS) in the AMI group had significantly lower Vmean values than the CS (p less than 0.001). Subendocardially (SIS) and transmurally (TIS) infarcted segments could be clearly separated from both CS and NIS (p less than 0.001). Per cent deviation of Vmean from the mean value of the control segments (PD-V) for SIS varied considerably overlapping CS, NIS and TIS. With a PD-V between 0 and -30% the probability of NIS is 94%, SIS 6% and TIS less than 1%. A PD-V more than -66% was rarely seen among NIS (2%) but was the normal finding in TIS (94%).

Nuclear cardiology: a comparison of equilibrium gated blood pool and gamma camera first-pass measurements for the assessment of left-ventricular regional wall motion

There are two major problems remaining for the successful assessment of left-ventricular regional wall motion (RWM) using nuclear cardiology. These are as follows. Which technique should be used: first pass or equilibrium? Secondly, which views should be used to give full information about the RWM of the left ventricle? This paper specifically considers each of these questions and concludes that equilibrium blood pool imaging in both the right anterior oblique and left anterior oblique projections is currently the best option.